Individual provider · Type 1 NPI

Ezra Gillego, RPA-C

Surgical Physician Assistant · New York, NY

NPI number 1407061393 Active

Practice location

1st Ave 16th Street
New York, NY 10003

Call (212) 420-2953 Map

Mailing address

464 E Beech St
Long Beach, NY 11561-3604

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400X011163 (NY)

Surgical Physician Assistant: Definition to come...

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About NPI 1407061393

Ezra Gillego, RPA-C's National Provider Identifier is 1407061393, issued on May 13, 2007. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in New York, NY. The record was last updated on Mar 11, 2014.